To understand the underlying structures of the skin. To gain a basic understanding of the process of wound healing.. To be able to identify different tissue types in areas such as the wound bed, wound edge and surrounding skin. ID: 663620
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Anatomy of the skinSlide2
Aims and objectives
To understand the underlying structures of the skin
To gain a basic understanding of the process of wound healing.
To be able to identify different tissue types in areas such as the wound bed, wound edge and surrounding skinSlide3
Anatomy of the skinSlide4
Is it important to know the Structure and functions of the skin?Slide5
How many layers does the skin consist of?Slide6
Largest and most visible organ
Made up of two main layers:
Epidermis – very thin layer and is firmly attached to the dermis at the dermo- epidermal junction.
Dermis- made up of two layers comprising of fibrous proteins, collagen and elastin which give skin its strength and elasticity.
Below dermis is subcutaneous layer , this provides support to the dermis and stores fat which protects the internal structures.Slide7
Does the skin vary in depth?Slide8
Thinnest over eyelids -O.1mm
Thickest over palms and soles of the feet – 1mm
The skin is the largest organ of the body it weighs between 6-8 1bs
It has a surface area of 20 square feet.Slide9
What are the functions of the skin?Slide10
Protection of internal structures – physical barrier to microorganisms and foreign matter.
Acid PH helps to prevent infectionSlide11
Allows you to feel pain, pressure heat this helps us to identify potential dangers and avoid injurySlide12
Thermoregulation- Blood vessels constrict or dilate to raise or lower body temperature. Sweat production promotes coolingSlide13
Transmits small amounts of water and body waste via sweat
Helps to prevent dehydration.Slide14
Metabolism-Photochemical reaction in the skin produces Vitamin D essential for metabolism of calciumSlide15
Absorption-Some substances can be absorbed directly into blood streamSlide16
Functions of the skin that declines with age.
Flattening of the dermal-epidermal junction, increased susceptibility to friction/ shearing forces resulting in blistering.
Decreased sensitivity to pain perception
Epidermis becomes thinner and flatter , uneven distribution of melanocytes leading to uneven pigmentation.
Skin becomes wrinkled due to depletion of elastic fibres.
Skin becomes dry as a result of atrophy of sebaceous glands
Baraboski (2003) and Beldon (2006)Slide18
How do wounds heal?Slide19
Classification of wound healing
Wounds that heal by primary intention e.g. incisional wounds
Wounds that heal by secondary intention e.g. pressure ulcers
Wounds that heal by tertiary intention e.g. delayed sutureSlide20
Wounds characterised by whether they are acute or chronicSlide21
No underlying aetiology i.e. trauma
Normal inflammatory phase
Heal and do not breakdownSlide22
Underlying pathology e.g. venous insufficiency
Persistent state of inflammationSlide23
Wounds go through 4 distinct phasesSlide24
Normal Wound Healing Response
MONTHS / YEARS
Starts immediately after injury.
Blood vessel contraction (vasoconstriction)
Occurs between 0-3 daysSlide27
20 days – 2 years
Closure of wound and re-epithelisation.
What factors may affect wound healing?Slide30
Factors Affecting Healing
Medications e.g.: Anti inflammatory, Cytotoxic drugs, steroids
Chronic health conditions
Systemic infection (Bowler & Davies, 1999
Factors affecting healing
Wound bed condition
Size of woundSlide32
Assessment of a wound is the responsibility of the qualified member of staff
You should ensure that this has been undertaken and a treatment plan has been established.Slide33
The selection of dressings or bandages without accurately undertaking a wound assessment taking into account underlying factors that may delay wound healing may result in costly treatments that are inappropriate and are not successful!Slide34
Clinical appearance of wound bed
Characteristics of granulation tissue
Does not bleed
Erythema and oedemaSlide43
Eczema and dry skinSlide44
Quantity – Small , moderate copious is dressing containing exudate?
Colour – Green? serous?, haemoserrous?
Consistency – Thick?Thin,Slide45
When does it occur?
How bad (intense) is it?
How does the patient
What makes it better?Slide46
If there are any changes in the wound report immediately to your nurse in charge
Any delay in a reassessment may result in inappropriate treatmentSlide47